Breast Implant size

Patients spend a lot of time in the office discussing size of the breast implant that they want. Nearly every day I hear patients say one of two things. Everybody seems to have a friend that tells them that you always wish you went bigger, or that you always wish you went smaller. It’s very interesting how two opposite statements seem to consistently occur during consultations. I always explain that their friend likely did not come to me for surgery, as my patient satisfaction rate with respect to both size and shape is better than 98%. How do we achieve that?

Firstly it is important not to perseverate too much on the size of the implant. The same implant, let’s say 300cc, can give a tiny 4’6″ woman a very large breast but make for a very small breast if chosen by a tall, broad woman. The important thing is the size of the implant relative to your body. Individualization is the cornerstone to excellence in plastic surgery outcomes, and so we spend a lot of time and effort in finding you the right size breast implant for your body- both in the consultation and in the operating room.

Secondly, lets not talk too much about cup size. The lack of standardization in the world of bra and lingerie designers is remarkable, and the same woman with a given breast size might go into Nordstrom and Macy’s and Victoria’s Secret and find herself fitting into a B or C or D cup bra, depending on the manufacturer and style. What I want to see in my consultation is the breast size that you want to achieve in real life, relative to your body. The size that YOU feel is a B or C or D cup is much more important to me than the size of bra that you can find to wear following your surgery.

There are many breast augmentation sizing techniques performed by plastic surgeons. Some surgeons tell their patients to fill a ziplock bag with rice and wear that in their bra at home to approximate the size of their anticipated breast implant. On the other side of the spectrum, some doctors use animated or computerized photographic manipulation to simulate what a particular implant would look like. In my practice, I have found that our outstanding success rate is facilitated by using actual breast implant sizers, placed in a bra, under your clothes during the sizing consultation. In this way I ask my patients to show me what they want to look like after the surgery, and we make note of this. We use MyTouchMD to take photos of our patients once they have found their ideal size, and you can refer back to those photos at home to anticipate your upcoming surgery.

Even then, however, I explain that in surgery the size of the sizer may or may or may not correlate to the final postoperative outcome. A sizer placed in a bra over the breast may look quite different than the same sized permanent sterile implant placed inside the breast during surgery. Here again I explain that it is important not to obsess on the number on the implant itself, but more important to concentrate on the shape of your breast and body that you are trying to achieve. It is my job the get you to that size and shape, and that may require a different numbered breast implant in surgery. There are two ways to go here… I tell each patient that they may choose the exact implant size and I will use that regardless of how it looks after surgery, OR that you can allow me to use my judgement in the operating room to achieve the size and shape that you show me in the pre-operative consultation. The vast majority of patients ask me to use my judgement.

Once in the operating room, I make the incision and then make the pocket for the breast implant. Using sterile breast implant sizers, I place a test implant of the size that was chosen into the pocket and then use the special operating room table to sit you up during the surgery. Remember that the patient is asleep during this process! IF the implant looks like it will provide the size and shape that we reviewed during the consultation, then that is the size of breast implant that we use. The sizer is removed, and a new, permanent breast implant is placed.

Sometimes, however, I feel that I need to use a bigger, smaller, or different shaped breast implant to achieve your goal. If that is the case, the sterile sizer implant is replaced with another different one so I can again sit you up and assess the new breast implant outcome. I may need to try three or four different implant sizes to get it just right, but the extra effort in the operating room pays off by providing a postoperative breast that best resembles the patient’s wishes. Once the final breast implant size and shape is decided on, a corresponding permanent sterile breast implant is opened and placed. Because of the volume of breast augmentation that we do, we keep a large number of breast implants of different sizes and shapes in our facility to have so many options available for each patient.

Further information on nuance techniques used during surgery to provide an optimal outcome can be found on the breast pages of our website. Suffice it to say that our excellent outcomes are not provided by chance, but instead by an investment in time, energy, and effort before and during your breast surgery.

If you are considering breast implant surgery, call our office at 805-969-9004 to schedule an appointment where we can talk more about breast augmentation, your goals, and the best way to achieve them.

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